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Neuralgia
How long does an intercostal neuralgia attack last?
Under normal circumstances, an episode of intercostal neuralgia usually requires about a week to improve. During this period, actively cooperating with treatment can lead to a quick recovery. Treatment typically involves orally administered non-steroidal anti-inflammatory and nerve-nourishing drugs, and it is necessary to reduce physical activity and minimize local irritation. It is crucial not to be exposed to the cold; local heat application is recommended. Commonly, a salt bag or toasted bran is used for heat application, which is quite sufficient. Applying heat twice a day, each time for more than half an hour, can enhance the effects significantly. Moreover, combining this with some physiotherapy methods, such as acupuncture, infrared therapy, and cupping, can yield very good results.
How to relieve neuralgia
Neuropathic pain can be relieved through treatments such as medication, physical therapy, and surgery. Medications used primarily include antiepileptic drugs and non-steroidal anti-inflammatory analgesics, such as carbamazepine, oxcarbazepine, gabapentin, pregabalin, sodium diclofenac, ibuprofen, and celecoxib. Physical therapy mainly involves localized heat application, massage, manipulation, and acupuncture. Surgical treatment is mainly suitable for patients who do not respond well to medication and physical therapy. Currently, the surgical approach mainly involves minimally invasive surgery to relieve nerve compression, thereby alleviating the symptoms of neuropathic pain. Beyond symptomatic treatment, it is important to identify and treat the underlying cause of the neuropathic pain, such as tumors, trauma, diabetes, etc. These causes can lead to neuropathic symptoms, so it is crucial to actively control these underlying diseases to potentially relieve neuropathic pain at its root. (Medications should be used under the guidance of a doctor.)
Symptoms of neuralgia
Neuralgia comes in many types and is generally quite severe. Patients may experience episodes of intense, short-lasting pain. The common symptoms include: Firstly, a classic type is trigeminal neuralgia, where patients primarily suffer from episodic severe pain in the areas innervated by the trigeminal nerve. This can feel like burning or electric shocks, and is often unbearable. Treatment usually requires antiepileptic drugs. The second major type of neuralgia commonly seen is postherpetic neuralgia, where pain is intense and follows the nerve distribution. Tricyclic antidepressants and antiepileptic drugs can be used for treatment. Additionally, peripheral neuropathy caused by diabetes can also lead to neuralgia. (Please use medication under the guidance of a doctor.)
How is intercostal neuralgia treated?
In our clinical practice, for intercostal neuralgia, we generally have the following treatment methods: The first type is oral medication, specifically non-steroidal anti-inflammatory drugs, which can alleviate pain. The second type is traditional Chinese medicine, such as drugs that invigorate blood circulation and remove blood stasis, which can also increase local blood circulation to relieve pain. The third method is to use acupuncture, which has comparatively good therapeutic effects on this type of intercostal neuralgia. Generally speaking, most cases of intercostal neuralgia do not last very long. Regardless of which method you choose, you can achieve relatively good results, so the above methods are the most common treatments for intercostal neuralgia. (Medication should be used under the guidance of a doctor based on specific circumstances.)
How to treat occipital neuralgia?
Occipital neuralgia is caused by cervical compression of the greater occipital nerve, leading to neuropathic pain. Thus, treatment of occipital neuralgia may involve oral pain relief medications to temporarily alleviate symptoms. Additionally, some nerve-nourishing medications can be used in treatment. Fundamental treatment involves addressing cervical spondylosis, which can include cervical physiotherapy and the use of medications that improve blood circulation and remove blood stasis to treat cervical spondylosis. It is also important to take care of the cervical spine by not sitting for too long; if sitting for extended periods, one should get up and move to stretch the muscles and bones. Performing the "little bird flying" exercise, where the head is leaned back and both arms are extended backwards, can effectively relieve cervical spondylosis and the pain caused by cervical compression of the greater occipital nerve. Additionally, the pillow should not be too high when sleeping at night.
Causes of Neuralgia
Neuralgia is extremely painful, with patients often experiencing severe, unbearable pain. The causes of neuralgia mainly include the following types. The first type to note is viral infection, such as herpes zoster virus infection, which can leave postherpetic neuralgia. In such cases, it is crucial to actively use antivirals and employ neuropathic pain medications for treatment. The second scenario may relate to nerve compression, such as trigeminal neuralgia, which may be associated with local vascular compression causing abnormal nerve discharges. Surgical treatment might be necessary to relieve the compression. Sciatica is also caused by compression of the sciatic nerve. The third case might be due to nonspecific inflammatory responses. For example, Guillain-Barre syndrome can also cause neuralgia, and treatment should be directed at the underlying cause.
Is occipital neuralgia the same as trigeminal neuralgia?
Occipital neuralgia and trigeminal neuralgia are different; these are two distinct diseases with different onset times, affected areas, and pain characteristics. Occipital neuralgia generally occurs in the back of the head and is associated with cervical spondylosis, neck muscle tension, spasms, injury, trauma, and inflammation, typically triggering pain in the distribution area of the greater occipital nerve. Trigeminal neuralgia generally affects the distribution area of the trigeminal nerve, causing very intense pain, which may be like lightning or a burning sensation. It is typically triggered by washing the face, brushing teeth, or touching and can start and stop suddenly.
How is neuralgia treated?
Neuralgia can cause severe pain and significantly impact a patient's life. Treatment for neuralgia primarily focuses on the following aspects: First, treatment should be based on the cause of the pain. For instance, if the patient suffers from trigeminal neuralgia, antiepileptic drugs may be prescribed. Surgery may be necessary in some cases. If the neuralgia is caused by a viral infection, active antiviral treatment is required. If tumor cells invade and cause the neuralgia, tumor treatment should be administered. The second type of treatment involves symptomatic management. This mainly includes medications to relieve neuralgia, commonly comprising tricyclic antidepressants and antiepileptic drugs, which can be effective in alleviating the pain and should be taken under the guidance of a doctor.
How to diagnose intercostal neuralgia
The examination for intercostal neuralgia includes two parts. The first part is to confirm whether it is indeed intercostal neuralgia, often based on three reasons. The first is pain that follows a semicircular path along the ribs. Second, there are usually fixed tender points or percussion points, also called trigger points, where pressing will cause pain and lead to a type of pain that radiates along the path of the intercostal nerves. The third is that it is more commonly seen between the fifth and ninth ribs, often causing pain or triggering increased pain during activities like sneezing or deep breathing. With this, it is basically possible to diagnose intercostal neuralgia. However, identifying the cause of intercostal neuralgia is very complex. The usual causes of intercostal neuralgia include five aspects: The first is congenital anomalies, the second is trauma, the third is tumors, the fourth is inflammation, and the fifth is other causes. Therefore, a complete diagnosis of intercostal neuralgia should not only confirm the presence of intercostal neuralgia but also identify the underlying cause. Only by treating the cause of the intercostal neuralgia can there be a very good treatment outcome.
How to relieve neuralgia
Firstly, symptomatic treatment can be administered to patients. Medications for treating neuralgia mainly include tricyclic antidepressants and anticonvulsants, and serotonin reuptake inhibitors may also be effective. These medications should be taken under the advice of a doctor when necessary to help alleviate pain. Secondly, localized block treatment can also achieve certain clinical effects. Thirdly, it is crucial to identify the cause of the neuralgia and treat it accordingly. For example, if a patient’s neuralgia is caused by optic neuromyelitis, corticosteroids should be used; if it is due to herpes zoster virus infection, antiviral medications are required.